What You Need to Know About Heroin

Heroin, horse, smack, cheese, gum. By
any name, it's a killer drug. Until recently, heroin was not thought to be a problem
among
children of middle-class parents. But lately, heroin has been showing up in new places.
Today the typical user could be a person from any race, part of the country, socio-economic
level, or age. It could be the child, teen, or adult next door.

Younger addicts account for some
dangerous new patterns in the way heroin is used:

It
can be the child's first drug experience. Children don't always start with
"gateway" drugs like marijuana, and then move up. A gateway drug is one that leads
to
other drugs.

It's a social activity. Heroin used to be thought of as something done alone.
Now it is sometimes used in a group setting such as teen parties.

This social use increases the risks of
spreading serious infections, such as HIV or Hepatitis C.

New image, worse danger

Heroin is made from morphine.
Morphine is found in the seed pods of some types of poppy plants. It is a very addictive
opiate.

Purer heroin is becoming more
common. But most street heroin is "cut" with one or more other substances. This means
that other substances are added to it. These may include antihistamines to help control
the stuffy nose and watery eyes that occur when snorting heroin. They can also include
other white powdery substances such as sugar, starch, powdered milk, or quinine. They
may even include strychnine or other poisons. Other drugs such as cocaine,
methamphetamine, or other opiates may also be mixed in. There might be only a little
heroin or even no heroin at all. And that can change with each dose a person gets.
Heroin users don't know the actual strength of the drug or what substance was used
to
cut it. So they are always at risk for overdose and death. Overdoses are common. It's
easy to take a dose that is too strong. This can cause users to stop breathing or
to
suffocate in their own vomit.

Users get high by snorting,
smoking, or injecting the heroin. Snorting and smoking have become more common because
high-purity heroin is available. Smoking and snorting is also more common because
users
fear getting an infection by sharing needles.

In an addicted person, withdrawal
occurs within a few hours after the last use. Withdrawal symptoms can be drug craving,
restlessness, muscle and bone pain, and vomiting. Symptoms peak between 48 and 72
hours
after the last dose. They last about a week. Symptoms can be very intense. The addicted
person may go back to using again if he or she doesn't get treatment for withdrawal
symptoms to help break the addiction cycle.

In the last few years, overdose deaths in the U.S. have skyrocketed.
In 2017 it was estimated that 72,000 people died of drug overdose. To put this in
perspective, 58,000 U.S. military service members died in the entire Vietnam War.
This
increased overdose death toll is mainly due to fentanyl being added to the heroin
supply. Fentanyl is another opioid that is 25 to 50 times stronger than heroin. Mixing
fentanyl with heroin leads to an incredibly strong drug that is easy to overdose and
die
from. To make matters worse, another dangerous opioid called carafentanil has also
been
found in the heroin supply. Carafentanil is 5,000 times stronger than heroin. It has
been linked to several deaths.

Parents, take note

Drug use experts tell parents that their best strategy is to be involved in their
children's lives and pay attention to everything that goes on.

They offer these specific suggestions:

Check out your children's friends. It's a red flag when children replace
old friends with new ones who have bad reputations.

Learn the signs of heroin use. Look for runny noses and eyes, pinpoint
pupils, and abnormal amounts of sleep. Wearing long sleeves in summer could be a
way to cover up needle marks on arms.

Pay attention to grades. A sudden drop in a child's grades could be a
warning. Talk with the child's teachers to see if they have noticed abnormal
behavior or other problems.

Look for clues. Syringes, tiny balloons or plastic bags, capsules and
packaging material for antihistamines can be signs of heroin use. Check the
coffee-bean grinder for unusual remains.

Ask your child's healthcare provider about drug use prevention
strategies. Some parents and schools have done urine or other drug testing on
children and teens. It's an extreme measure. But if you believe one of your
children is on heroin, it could be a lifesaver. Ask your child's provider to
recommend a testing facility. Over-the-counter testing kits are also available
from pharmacies or online.

If you believe your child has a
drug problem, take it seriously. Talk with a professional drug counselor to find out
which resources are available for your child and the best way to get involved. Your
child's healthcare provider or teacher may be able to recommend a counselor or substance
use treatment program to contact. The Substance Abuse and Mental Health Services
Administration has a drug abuse information and treatment resource locator available
on
its website.